Paediatric cholesterol tests and the adoption of an ‘adolescent cholesterol passport’ could help prevent up to one-fifth of premature heart disease, a new study has revealed.
The research shows that elevated levels of cholesterol and an imbalance of lipids, known as dyslipidaemia, in children and adolescents increases the risk of heart issues such as subclinical atherosclerosis in their mid-20s and premature death by their mid-40s.
Scientists from the Universities of Exeter, Bristol and Eastern Finland found that earlier cholesterol checks, such as universal paediatric lipid screening, could reduce the number of adults suffering from preventable heart disease.
Related Article: Troponin measure needed to accurately predict cardiovascular risk, say researchers
The findings are published in Atherosclerosis.
Cardiovascular disease is the leading cause of death globally, with the World Health Organization estimating that the disease causes 17.9 million deaths each year of heart disease. High cholesterol levels in adolescence are known to cause structural and functional damage to the heart, leading to premature cardiac damage and death.
Using data from the University of Bristol’s Children of the 90’s cohort, also known as the Avon Longitudinal Study of Parents and Children, the researchers analysed data from 1,595 adolescents at the age of seventeen and followed up with each participant for seven years. Cholesterol levels and evidence of heart damage were assessed at the start and throughout the follow-up period.
The scientists found an eighteen to twenty per cent increased risk of premature heart damage in adolescents with increased low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and higher overall cholesterol levels.
An increase in triglycerides was also found to be associated with up to a three-fold increase in the risk of premature heart damage within seven years.
Related Article: Sign up to Nursing in Practice’s free virtual cardiology event
Dr Andrew Agbaje, lead author of the study from the University of Exeter, said: ‘We are seeing the first evidence of the catastrophic effects of elevated cholesterol levels on the heart more than two decades before the age of 40 – which is when current health guidelines recommend cholesterol check. Waiting until the age of 40 years might result in one in five of the adult population developing preventable heart problems.’
Elevated cholesterol levels were seen in both adolescents of a healthy weight and those considered overweight or obese. The findings also revealed that while increased cholesterol was responsible for around a third of the direct damage to the heart, increased fat mass and blood pressure indirectly contributed to around forty per cent of heart damage. The researchers showed that genetics and sedentary time could explain the remaining thirty per cent of damage.
Dr Agbaje added: ‘Recently we discovered that increased sedentary time from childhood contributed seventy per cent of the increase in cholesterol level before mid-20s and that engaging in light physical activity can completely reverse elevated cholesterol and dyslipidaemia. Taken together, these findings suggest that being sedentary is at the root of health problems and childhood and adolescent sedentariness is a one-way ticket for cardiovascular diseases and death.’
Related Article: Lipid management: What primary care nurses need to know
The researchers state that public health experts, paediatricians, parents, and health policymakers should encourage early cholesterol checks, especially in the teenage years, to reduce the risk of dyslipidaemia and to enable early preventive treatment.
